Preseptal cellulitis caused by trichophyton (ringworm).

A 10-year-old boy with a past medical history significant for chicken pox at 7 years of age was referred to our eye center by an outside ophthalmologist for a 15-day history of worsening right-sided preseptal cellulitis. The patient reported photophobia, pruritus, and pain in the eyelid region. There appeared to be vesicular lesions on the eyelids. Empiric therapy with oral antibacterial and antiviral medications failed to resolve the preseptal cellulitis. Lid cultures revealed coagulase negative Staphylococcus, Streptococcal viridans, and a Trichophyton species of fungus. The infection was successfully treated with two courses of oral itraconazole. This is the first case of preseptal cellulitis caused by this dermatophyte that we could find in the literature.